SARS-CoV-2 infection among people living with HIV compared with people without HIV: Survey results from the MACS-WIHS combined cohort study

Gypsyamber D'Souza, Weiqun Tong, Deborah Gustafson, Maria L. Alcaide, Cecile D. Lahiri, Anjali Sharma, Audrey L. French, Frank J. Palella, Mirjam Colette Kempf, Matthew J. Mimiaga, Catalina Ramirez, Seble Kassaye, Charles R. Rinaldo, Todd T. Brown, Phyllis C. Tien, Adaora A. Adimora

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) symptoms among people living with HIV (PLWH) are not well described. Setting: Longitudinal survey within the MACS/WIHS Combined Cohort Study (MWCCS) of PLWH compared with similar HIVseronegative (SN) individuals. Methods: Telephone-administered survey of MWCCS participants at 13 clinical research sites across the United States addressing COVID-19 symptoms, SARS-CoV-2 testing, and pandemic impact on social distancing and antiretroviral therapy (ART) use. Primary data collection occurred during May (wave 1), June-July (wave 2), and August-September, 2020 (wave 3). Results: One-third of MWCCS participants were tested for SARSCoV- 2 infection; 10% was tested ≥2 times. Similar proportions of PLWH and SN participants were tested, but SARS-CoV-2 positivity was higher among PLWH than among SN individuals (9.4% vs 4.8%, P = 0.003). Odds of SARS-CoV-2 positivity remained higher among PLWH after adjusting for age, sex, race/ethnicity, and study site (adjusted odds ratio = 2.0, 95% confidence interval = 1.2 to 3.2). SARS-CoV-2 positivity was not associated with CD4 cell counts among PLWH. Among SARS-CoV-2 positive participants, 9% had no symptoms, 7% had 1-2 mild symptoms, and 84% had ≥3 symptoms. Most of the (98%) participants reported physical distancing during all survey waves; self-reported ART adherence among PLWH was not adversely affected during the pandemic compared with the previous year (similar adherence in 89% of participants, improved in 9% of participants, and decreased in 2% of participants). Conclusions: Despite similar SARS-CoV-2 testing and physical distancing profiles by HIV serostatus among MWCCS participants, PLWH who reported SARS-CoV-2 testing were more likely to have a positive test result. Additional studies are needed to determine whether and why PLWH are at increased risk of SARS-CoV-2 infection.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number1
StatePublished - Jan 1 2022


  • CD4
  • Coronavirus
  • Distancing
  • PLWH
  • Symptoms
  • Testing

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)


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